Disease Control Newsletter (DCN)

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Guillain-Barré Syndrome, 2010

In 2009, Guillain-Barré syndrome (GBS) was added to the Minnesota Rules Governing Communicable Diseases for a duration of 2 years. While not an infectious disease, it was added to aid post-licensure safety monitoring of the 2009 novel influenza A H1N1 vaccine. Enhanced surveillance was conducted October 1, 2009 through May 31, 2010.

As part of EIP, Minnesota was one of 10 states which monitored the safety of the 2009 influenza A H1N1 vaccine. MDH established a network with all neurology clinics statewide that reported suspected GBS cases weekly. In addition, all hospital medical records departments screened discharge records biweekly to assure no GBS cases were missed. MDH reviewed medical records using a standardized case report form for each suspect GBS case. Information on antecedent infections and vaccination history, including influenza A H1N1 vaccine, in the 42 days prior to onset of GBS symptoms was collected. Case status was assigned according to Brighton clinical criteria.

Between January 1, 2010 and May 31, 2010, MDH investigated 90 reports of possible GBS. Of these, 27 (30%) cases had confirmed GBS, 1 (1%) case had probable GBS, 61 (68%) were non-cases, and 1 (1%) was an out of state resident. Nationally, CDC is evaluating whether there is an excess risk of GBS related to influenza A H1N1 vaccination; preliminary data showed a slightly increased risk of 0.8 excess cases per million vaccinees, no different than the excess risk associated with some seasonal influenza vaccines.